22 September 2016
During an inspection looking at part of the service
At our last inspection we were concerned that people were not being kept safe. There were not enough staff on duty and staff were not being delegated to meet people’s needs. People could not be certain their medicines would be managed and administered safely. The nursing care provided had not consistently been well planned or delivered to ensure people’s health care needs were met. At this inspection we found significant improvements had taken place however people were still not receiving a service that was consistently providing safe care.
Ivyhouse is registered to provide nursing care and accommodation for up to 76 older people who may also be living with dementia. At the time of our inspection there were 27 people living at Ivyhouse on Daffodil and Cornflower Units. During our inspection people were being assessed for new care homes and some people were being supported to move out.
There was no registered manager in post, but the registered provider had ensured someone was in day to day control of the home. They were present throughout our inspection and were supported by a member of the registered provider’s management team. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.
We completed this unannounced inspection on 22 September 2016. We planned this inspection to provide assurance that plans were in place to provide an adequate level of care and support to people until the home closes. We only looked at the key question of safe. This report only covers our findings in relation to the key question of safe. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Ivyhouse on our website at www.cqc.org.uk.
While the provider had taken some action to improve the management of medicines this was not consistent across the home. Medicated creams and tablets administered directly from boxes were not well managed. People could not be confident they would always receive these as prescribed.
Risks people were exposed to because of their medical conditions had not always been identified, assessed and well planned for. People could not be confident they would always receive care that protected them from harm.
Although there were less people using the service the provider had not reduced the number of staff working at the service. This had resulted in staff having more time to spend with people and time to focus on their needs. People told us the staff were caring and responsive to their needs. People told us they felt safe and medicines that were administered from a blister pack were well managed.
People told us they enjoyed the food and we observed people being provided with the support they needed to eat and drink. People appeared well presented and staff took action when necessary to maintain their dignity. People were supported when necessary to access a range of health care professionals.
A range of checks and audits had been developed to drive forward improvement at this service and to ensure people safely received the care and support they required until they left the service.
As Ivyhouse is a service in special measures it will be kept under review while it is open. Where necessary, another inspection will be conducted whilst the home remains open. The findings of future inspections could lead to us taking urgent action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.